Abdominal Pain in Elementary Kids

[fetch, BSN, RN]

3rd grade student has reported stomach pain several times the past week. Today came in clutching right abdomen, right about mid between RUQ and RLQ. No fever, no constipation, no vomiting. Pain increased on palpation but not rebound tenderness. After 2 small cups water - and two of his friends came in for ice and left - he volunteered "I feel better now."

My instincts are telling me on one hand "frequent flyer wanted to get out of class" and on the other hand "WARNING WARNING APPENDIX DON'T IGNORE THIS." I've sent him back to class but feel I should call mom?

Any advice?

[Flare, ASN, BSN]

i'd make the FYI call - explain the symptoms and frequency and inquire about whether or not this is seem at home. Also be sure to ask about any issues with consitpation. You're liable to get a reply from mom along the lines that their kid is a class "A" malingerer and should be shown the door immediately. At the very least, you've brought the situation to the parent's attention so if something more serious is going on, you've covered your behind. And who knows, maybe by letting the parent know, the parent can have a talk with their little hypochondriac and the visits will stop.

[100kids, BSN, RN]

I would make that call home as well. This way they are looking out for any problems when they're home as well. I always like to let parents know if I've seen their child often for a recurring problem. Even if I think it's frequent flyer-itis it may prompt a conversation from mom to the child about coming to the Nurse's office unnecessarily or it may let mom know something is going on.

[NutmeggeRN, BSN]

Oh yeah, call home for sure and document that as well. Sometimes I will shoot an email, "pursuant to our conversation this morning re Johnny, if things are no better then I would suggest you follow up with his PCP". Creates a digital trail (if they have email) most of my parents do.

Good Luck!

[fetch, BSN, RN]

Thanks for the advice - I tried calling home but no working numbers, a frequent problem around here! I sent home a letter with "warning signs" to look out for if it gets worse.

[NutmeggeRN, BSN]

Thanks for the advice - I tried calling home but no working numbers, a frequent problem around here! I sent home a letter with "warning signs" to look out for if it gets worse.

Call the kiddo down and ask them if they know the number, this info changes a lot...the kiddo may know how to find mom or dad

Good Luck!

[fetch, BSN, RN]

Not for this student, but for another I tried that -- got some interesting "numbers" in response! And very confused people, when I did get a full 7 digits out of the child.

[sharpeimom]

I have (among other types) abdominal seizures. The discomfort is felt in the area you described. Sometimes it can be the only type of seizure a child has. A burp or bowel movement can alleviate symptoms. As a kid, an abdominal seizure caused horrendous trapped gas and diarrhea for me.

This type of seizure will show up as seizure activity on an EEG.